Mechanical Test MAR/30/2023/THU 09: 46 FAX No, P, 006
ANNUAL RPZ T55T REPORT
SMI Job# Z302-0340P
JOB ADDRESS: CITY: STATE: ZIP CODE:
4201 Sunset Dr. S tring Park MN 55384
OWNER/OCCUPANT BUILDING NAME; DESCRIPTION OF WORK: ANNUAL X
The Mist on Lake Minnetonka INSTALL I ALTER I REPAIR REPLACE OVERHAUL
Apartments The Mist
CONTACT PERSON: TELEPHONE NUMBER:
Barbie 952-471-2428
SYSTEM SERVED: DEVICE LOCATION: FLOOR#: ROOM#:
Humidifier Mechanical Room 5th Mechanical
MODEL: SIZE : SERIAL/#:
WATTS 009 M3 3 4" 247033
TEST DATE: OVERHAUL DATE : INSTALL DATE: PREVIOUS OVERHAUL DATE :
3 23 2023 7 15 201l
CHECK VALVE CHECK VALVE PRES. DIFF.ACROSS PRE$, DIFF. WHEN STRAINER
NUMBER 1 NUMBER 2 NUMBER 1 CHECK RELIEF OPENS
INITIAL LEAKED LEAKED X NONE
TEST X1 CLOSED X CLOSED 8,0 PSI 3.0 PSI CLND
R INITIAL TEST PASSED, SUBMIT AS FINIAL INITIAL TEST FAILED, REPAIR NEEDED
DESCRIBE REPAIR :
CHECK VALVE CHECK VALVE PRES. DIFF.ACROSS PRES. DIFF. WHEN
NUMBER 1 NUMBER 2 NUMBER 1 CHECK RELIEF OPENS
INITIAL LEAKED LEAKED
TEST CLOSED CLOSED PSI PSI
TEST PERFORMED BY: CERTIFICATION NUMBER:
)ohn lalrosi:ewicz BF020215
COMPANY NAME: COMPANY ADDRESS : :_dn
STATE: ZIP CODE:
Stynature 8260 Arthur Street NE Spg Cake
MECHANICAL Suite A Park MN SS432
SIGNATURE MECHANICAL, INC.
8260 Arthur Street NE
SPRING LAKE PARK, MINNESOTA 55418
PHONE : 763-788-9844 FAX : 76S-788-9868
MAR/30/2023/THU 09:46 FAX No, P. 004
ANNUAL RPZ TEST RIEPORT �I
SMI Job# 2302-0340P
JOB ADDRESS: CITY: STATE: ZIP CODE:
4201 Sunset Dr. S rin Park MN 55384
OWNER/OCCUPANT BUILDING NAME: DESCRIPTION OF WORK: ANNUAL X
Th.e Mist on Lake Minnetonka INSTALL ALTER REPAIR REPLACE OVERHAUL
Apartments The Mist
CONTACT PERSON: TELEPHONE NUMBER:
Barbie 952-471-2428
SYSTEM SEFZVFD: DEVICE LOCATION: FLOOR#: ROOM#:
Irrigation Mechanical Room Parking Garage Mechanical
MAKE: MODEL : SIZE : SERIAL#:
WATTS 009 M2 2" 266628
TEST DATE: OVERHAUL DATE: INSTALL DATE : PREVIOUS OVERHAUL DATE :
3 23 2023 7 15 2011
CHECK VALVE CHECK VAI-VE PRIES. DIFF.ACROSS PRES. DIFF. WHEN STRAINER
NUMBPR 1 NUMBER 2 NUMBER 1 CHECK RELIEF OPENS
INITIAL LEAKED LEAKED X NONE
TEST CLOSED X CLOSED 8,0 PSI 3.0 PSI CLND
X INITIAL TEST PASSED, SUBMIT AS FINIAL INITIAL TEST FAILED, REPAIR NEEDED
DESCRIBE REPAIR :
CHECK VALVE CHECK VALVE PRES. DIFF, ACROSS PRES. DIFF,WHEN
NUMBER 1 NUMBER 2 NUMBER 1 CHECK RELIEF OPENS
INITIAL LEAKED LEAKED
TEST CLOSED CLOSED PSI PSI
'[EST PERKORMED BY: CERTIFICATION NUMBER :
John jarosiewicz I BF020215
COMPANY NAME : COM ANY ADDRESS.: CITY: STATE: ZIP CODE :
Sl mature 8260 Arthur Street NE Spring Lake
MECHANICAL Suite A Park I�MN 55432
SIGNATURE MECHANICAL, INC,
8260 Arthur Street NE
SPRING LAKE PARK, MINNESOTA 55418
PHONE: 763-788-9844 FAX: 763-788-9868
MAR/30/2023/THU 09: 46 FAX No, P. 005
ANNUAL RPZ TEST REPORT
SMI Job# 73OZ-0340P
JOB ADDRESS: CITY: STATE: ZIP CODE:
4Z01 Sunset Dt'. S ring Park MN 55384
OWNER/OCCUPANT BUILDING NAME: DESCRIPTION OF WORK: ANNUAL 1XI
The Mist on Lake Minnetonka INSTALL I ALTER I REPAIR REPLACE OVERHAUL
Apartments The Mist
CONTACT PERSON: TELEPHONE NUMBER:
Barbie 952-471-2428
SYSTEM SERVED: DEVICE LOCATION: FLOOR#: ROOM#:
Humidifier Roof Penthouse Penthouse
MAKE: MODEL : SIZE: SERIAL AL#:
WATTS 009 M3 3 4" 247029
TEST DATE : OVERHAUL DATE : INSTALL DATE ; PREVIOUS OVERHAUL DATE :
3 23 2023 2 11 2020
CHECKVALVE CHECKVALVE PRES. RIFF. ACROSS PRE$, RIFF,WHEN STRAINER
NUMBER 1 NUMBER 2 NUMBER 1 CHECK RELIEF OPENS
INITIAL LEAKEEF LEAKED 2�j NONE
TEST CLOSED X CLOSED 9.8 PSI 4.0 PSI CLND
INITIAL TEST PASSED, SUBMIT AS FINIAL I INITIAL TEST FAILED, REPAIR NEEDED
DESCRIBE REPAIR :
CHECK VALVE CHECK VALVE PRES. DIFF. ACROSS PRES. pIFF, WHEN
NUMBER 1 NUMBER 2 NUMBER 1 CHECK RELIEF OPENS
INITIAL LEAKEE-F LEAKED
TEST I CLOSED CLOSED PSI PSI
TEST PERFORMED BY: CERTIFICATION NUMBER :
John larosiewicz I BF020215
COMPANY NAME : COMPANY ADDRESS : CITY: STATE : ZIP CODE :
,S`iBnature 8260 Arthur Street NE Spring Lake
MECHANICAL Suite A Park Mai 55432
SIGNATURE MECHANICAL, INC.
8260 Arthur Street NE
SPRING LAKE PARK, MINNESOTA 55418
PHONE: 763-788-9844 FAX : 763-788-9868